Diagnostic Accuracy of Nasal Endoscopy as Compared to Computed Tomography in Chronic Rhinosinusitis
AbstractThe study was done with the aims to evaluate the accuracy of nasal endoscopy as compared to computed tomography (CT) in diagnosing chronic rhinosinusitis (CRS) and to evaluate the correlation between Endoscopy Score and CT Score. It was a cross sectional study. Every consecutive, symptomatic patient of CRS who fulfilled the criteria of American Academy of Otolaryngology —Head and Neck Surgery Task Force were included in the study. Rigid diagnostic nasal endoscopy (DNE) was done and Lund-Kennedy scoring system was used. Plain CT of paranasal sinuses was done on the same day and severity was assessed using Lund-Mackay scoring system. Results were analysed consideri ng CT as a gold standard. Out of 54 study patients, 45 (83.33%) had abnormal endoscopic examination while 50 (92.59%) were showing positive CT scan. Sensitivity and specificity of DNE against CT scan were 94% (95% CI 81.43–98.33%) and 75% (95% CI 42–99.24%), respectively. The positive predictive value was 98% and negative predictive value was 67%. Correlation between Lund-Mackay overall CT and Lund-Kennedy Endoscopy Score was high [Pearson’s correlation coefficient (r) = 0.881,p value
Authors: Napolitano L, Waku M, Maggi G, Ciarelli F Abstract Cystic intestinal pneumatosis (CIP) is the presence of gas bubbles inside the wall of the intestine. In literature it has been reported to be associated with a variety of clinical conditions such as: superior mesenteric ischemia, intestinal perforation, bowel necrosis, infections which can cause mucosal alterations and therefore increasing its permeability, necrotizing enterocolitis in babies, trauma, intestinal obstruction, autoimmune and pulmonary pathologies. Its presence is usually documented by radiological techniques such as abdominal X-ray, CT scan ...
A 29-year-old woman presented with 7 years of abdominal pain, distension, bloating, incomplete rectal evacuation, and food intolerance. Prior gastrointestinal endoscopies, abdominal ultrasound, and computerized tomography (CT) scans were nondiagnostic. Abdominal examination showed distension, tympanic percussion note, and general tenderness, but no guarding or rebound. Rectal examination showed high anal sphincter tone, levator muscle tenderness, no perineal descent, and anal contraction while straining to evacuate the examining finger.
PMID: 29907465 [PubMed - as supplied by publisher]
Conclusions This survey shows that there is no standardized guideline for diagnostic work-up or management of anastomotic leakage and that there is a need for an international guideline regarding the optimal management of anastomotic leakage.
ConclusionVenous resection will be more frequently done with LPD and vascular grafts more frequently needed. Compared to other available vascular grafts (autogenous, synthetic, cadaveric and bovine pericardium, etc), the parietal peritoneum had the advantages of being rapidly available, easy to harvest by the laparoscopic approach, not expensive, no need for anticoagulation and at lower risk of infection.
CONCLUSIONS: This survey shows that there is no standardized guideline for diagnostic work-up or management of anastomotic leakage and that there is a need for an international guideline regarding the optimal management of anastomotic leakage. PMID: 29883644 [PubMed - as supplied by publisher]
Rationale: Primary mucoepidermoid carcinoma (MEC) of the esophagus is a rare type of malignant neoplasm. Its morphology resembles that of MEC of the salivary glands. It is characterized by a diffuse mixture of squamous and mucus-secreting glandular carcinoma cells. Due to the low incidence of esophageal MEC, the biological behavior and treatment of this tumor have not been well studied. Patient concerns: In this case report, we describe a case of a 59-year-old man who presented with difficulty in swallowing. Iohexol swallowing revealed a malignant-appearing structure in the inferior-thoracic region. Diagnoses: Biop...
ConclusionUse of the AM route to place the cervical anastomosis within 1.5 cm above the suprasternal notch might avoid excessive pressure on the gastric tube from the surrounding structures, resulting in a reduction in the risk of an anastomotic leak.
Conclusion: GI is associated with complications secondary to diagnostic delay and its late surgical resolution, although the initial treatment is aimed at resolving the intestinal obstruction through enterotomy and gallstone extraction, there is controversy regarding the preferred time for cholecystectomy and repair of biliary-enteric fistula, being the two-stage surgery the surgical procedure of choice, especially in patients with a high risk of complications. PMID: 29809187 [PubMed - in process]
35 y/o female who underwent a Whipple procedure for a pancreatic neuroendocrine tumor presents with progressive nausea and emesis over the past year. Her post-operative course was complicated by complete mesenteric thrombosis requiring a Sugiura Procedure. A CT Scan demonstrated massive dilation of the afferent limb to the gastrojejunostomy suggestive of Afferent Loop Syndrome. The patient underwent upper endoscopy demonstrating a widely patent afferent outlet with a stenosed efferent limb at the gastrojejunostomy.